Health technology assessment : HTA
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Multicenter Study Clinical TrialPreoperative behavioural intervention to reduce drinking before elective orthopaedic surgery: the PRE-OP BIRDS feasibility RCT.
Heavy alcohol consumption is associated with an increased risk of postoperative complications and extended hospital stay. Alcohol consumption therefore represents a modifiable risk factor for surgical outcomes. Brief behavioural interventions have been shown to be effective in reducing alcohol consumption among increased risk and risky drinkers in other health-care settings and may offer a method of addressing preoperative alcohol consumption. ⋯ The evidence supports the feasibility of a definitive trial to assess the effectiveness of brief behavioural intervention in reducing preoperative alcohol consumption and for secondary outcomes of surgical complications if recommendations for further improvements are adopted.
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Clinical TrialAn intervention for parents with severe personality difficulties whose children have mental health problems: a feasibility RCT.
The children of parents with severe personality difficulties have greater risk of significant mental health problems. Existing care is poorly co-ordinated, with limited effectiveness. A specialised parenting intervention may improve child and parenting outcomes, reduce family morbidity and lower the service costs. ⋯ The Helping Families Programme-Modified is an acceptable specialised parenting intervention. Trial methods using non-diagnostic criteria were largely supported. For future work, a definitive efficacy trial should consider site selection, recruitment methods, intervention efficiency and revised comparator condition.
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Multicenter Study Clinical TrialSilver-impregnated, antibiotic-impregnated or non-impregnated ventriculoperitoneal shunts to prevent shunt infection: the BASICS three-arm RCT.
Insertion of a ventriculoperitoneal shunt to treat hydrocephalus is one of the most common neurosurgical procedures worldwide. Shunt infection affects up to 15% of patients, resulting in long hospital stays, multiple surgeries and reduced cognition and quality of life. ⋯ A sample collection has been established that will enable the study of surrogate markers of ventriculoperitoneal shunt infection in cerebrospinal fluid or blood using molecular techniques. A post hoc analysis to study factors related to shunt failure will be performed as part of a future study. An impact analysis to assess change in practice is planned.
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Clinical Trial Pragmatic Clinical TrialDementia Care Mapping™ to reduce agitation in care home residents with dementia: the EPIC cluster RCT.
The quality of care for people with dementia in care homes is of concern. Interventions that can improve care outcomes are required. ⋯ Alternative models of DCM implementation should be considered that do not rely solely on leadership by care home staff.
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Health Technol Assess · Mar 2020
Randomized Controlled Trial Multicenter Study Clinical TrialC-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT.
Most patients presenting with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in primary care are prescribed antibiotics, but these may not be beneficial, and they can cause side effects and increase the risk of subsequent resistant infections. Point-of-care tests (POCTs) could safely reduce inappropriate antibiotic prescribing and antimicrobial resistance. ⋯ Implementation studies that also build on our qualitative findings could help determine the effect of this intervention over the longer term.